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Deactivated NPI 1992252399 Deactivated / Inactive NPI Female Practitioner

Lisa Moran , NP

Registered Nurse • Mchenry, IL

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Lisa Moran has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 02, 2016
NPI Deactivation Date February 05, 2026
Total Practice Duration ~10 Years of Practice (2016 – 2026)

Professional Overview & Biography Verified Profile Summary

Lisa Moran, NP was a registered Registered Nurse practicing in Mchenry, IL. Throughout an active medical career spanning 10 years, Lisa Moran provided care at the practice location at 4309 W MEDICAL CENTER DR until profile deactivation on 2026-02-05.

Historical Medicare Part B clinical services included established patient outpatient office visit, physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent, routine ekg using at least 12 leads including interpretation and report. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

4309 W Medical Center Dr
Suite A200

Mchenry, IL 600508419

Telephone 8157598070
Fax 8157594931
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Registered Nurse in Mchenry, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.4 Yrs
Regional Practice Density
18 Specialists

Practicing in Mchenry, IL (2714 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
50.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2020)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
24 23 $185.00 $90.89

Medical Specialties & State Licenses

Registered Nurse Primary Specialty

NUCC Taxonomy Code: 163W00000X

State License IL 041346499

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

29 Associated Practitioners
Dr. Asim Zaidi , MD

Internal Medicine - Interventional Cardiology

NPI 1063641181

Doctor of Medicine (M.D.)

Dr. Mohammad Kizilbash , MD

Internal Medicine - Cardiovascular Disease

NPI 1114162948

Doctor of Medicine (M.D.)

Justin Duffy , PA-C

Physician Assistant

NPI 1174918809

Physician Assistant (Certified)

Judi Forner

Clinical Nurse Specialist - Adult Health

NPI 1194123679
NPI 1205609351

Advanced Practice Registered Nurse, Certified Nurse Practitioner

NPI 1205665478

ACNP, Certified Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
⚠️
NPI Profile Deactivated February 05, 2026

Record deactivated on February 05, 2026

📍
Updated Business Mailing Address September 01, 2020

Registered at 4309 W MEDICAL CENTER DR STE A200, MCHENRY, IL 600508437 (Tel: 8157598070)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 01, 2020

Nurse Practitioner (License #209015062 in IL)

NPI Profile Active August 09, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location August 09, 2017

Registered at 360 STATION DR STE 120, CRYSTAL LAKE, IL 600147994 (Tel: 8154778900)

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Updated Business Mailing Address August 09, 2017

Registered at 5418 CROSSVIEW LN, LAKE IN THE HILLS, IL 601565885 (Tel: (224) 678-6805)

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Provider Name / Credentials Updated August 09, 2017

Recorded as LISA MORAN, N.P.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 09, 2017

Registered Nurse (License #041346499 in IL)

NPI Profile Active September 02, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location September 02, 2016

Registered at 4309 W MEDICAL CENTER DR, SUITE A200, MCHENRY, IL 600508419 (Tel: 8157598070)

📍
Updated Business Mailing Address September 02, 2016

Registered at 4309 W MEDICAL CENTER DR, SUITE A200, MCHENRY, IL 600508419 (Tel: 8157598070)

👤
Provider Name / Credentials Updated September 02, 2016

Recorded as LISA MORAN, N.P.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2016

Registered Nurse (License #041346499 in IL)

🟢
Initial NPI Registration & Enumeration September 02, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992252399
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 02, 2016
Last Update: September 02, 2016
Deactivation Date: February 05, 2026

Mailing Address

4309 W Medical Center Dr, Suite A200

Mchenry, IL 600508419

Phone: 8157598070

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.